Special Investigator II

🕒 Yesterday

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

SageSure

WebsiteLinkedInAll Job Openings

501 - 1000 employees

👥 B2C

💸 Finance

Insurance • B2C • Finance

SageSure is a leading provider of property insurance products to homeowners and small businesses in coastal states. As an innovation-focused company, SageSure utilizes advanced technology to offer tailored insurance solutions, ensuring comprehensive coverage and risk management.

📋 Description

• Applies knowledge and understanding of fraud schemes and investigation strategies on any questionable or suspect first or third-party claims. • Participates in the development of fraud prevention strategies. • Applies knowledge of insurance industry products, services and processes in investigating claims. This includes insurance policy contracts, coverages and internal claims handling process and procedures. • Applies knowledge of state laws and regulations pertaining to insurance fraud in investigating claims. • Collects evidence of potential fraud through remote interviews and thorough searches of investigative databases, internal resources, Internet resources, public records, and forensic tools. • Makes recommendations within defined authority guidelines. • Prepares and presents detailed and comprehensive verbal and written investigative reports summarizing the results of the investigation and recommended outcome. • Establishes and maintains external relationships with industry, law enforcement and other contacts involved in fraud investigation, detection and prevention. • May serve as a resource team member on specific matters through demonstrated skill or training. • Assists with the delivery of fraud awareness training initiatives in a defined environment. • Handles CAT duty responsibilities as business requires. • Identifies and handles existing and emerging risks that stem from business activities and the job role. • Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled. • Follows written risk and compliance policies and procedures for business activities.

🎯 Requirements

• Bachelor's degree in a related field or equivalent relevant education. • A minimum of 4 years of comprehensive experience in P&C SIU/Fraud investigations or 6 years in a related fraud industry investigation role. • Demonstrated knowledge and understanding of fraud investigations, including familiarity with case law, state laws, and regulations. • Ability to obtain or possess a P&C adjuster's license within 90 days of employment. • Track record as an investigator with experience in conducting statements involving multiple parties. • Proficiency in gathering evidence and making conclusions based on objective details related to fraud applicability. • Ability to effectively organize and prioritize workloads, handle multiple tasks, and devise solutions for problems. • Proficiency in using computers and software packages to input and extract data for analysis from pertinent data sources and systems. • Knowledge of city, state, and local regulations, legal principles, contract understanding, case law, medical treatment, and medical terminology. • Experience in managing specialty/complex/litigated claims and cases.

🏖️ Benefits

• Health insurance • 401(k) matching • Flexible work hours • Paid time off • Remote work options